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PubMed2004

Interstitial cystitis.

Interstitial cystitis (IC) is still considered a rare disease, but in the future its incidence will probably be revised if tendency is that of considering interstitial cystitis on the basis of clinical rather than endoscopic-histological criteria. According to some urologists, cystodistension and vesical biopsy, even if not pathognomonic, are still effective up till now, at least for their prognostic-therapeutic value as well. If on one hand in the diagnosis of this condition symptoms tend to be of more and more value unlike instrumental investigations, on the other hand little has changed in therapy.

Adult↗
PubMed1992

[Emphysematous cystitis. Apropos of a case].

Emphysematous cystitis is a rare complication of lower urinary tract infection, occurring almost exclusively in diabetic women. The prognosis, usually good, depends on early diagnosis and prompt treatment which consists of urinary drainage, antibiotic therapy and strict blood glucose control. The authors report a case of emphysematous cystitis diagnosed on laparotomy for acute abdomen. Death occurred despite treatment.

Aged↗
PubMed2004

[A 34-year-old man with hemorrhagic cystitis].

BACKGROUND: A 34-year-old male presented with macroscopic haematuria, abdominal pain and dysuria while being treated with penicillin for bacterial endocarditis. All blood cultures yielded Streptococcus mutans. After four weeks of treatment he developed haemorrhagic cystitis, thrombophlebitis and eosinophilia. The symptoms disappeared when he was taken off penicillin. After change of medication to ceftriaxone, the patient developed reversible neutropenia and recovered completely. INTERPRETATION: Haemorrhagic cystitis caused by penicillin can be potentially fatal; two cases have earlier been described. Because of cross reaction this patient also developed reversible neutropenia. It is well known that beta-lactam antibiotics can induce severe neutropenia.

Adult↗
PubMedDate not supplied

Loracarbef versus cefaclor in the treatment of cystitis and asymptomatic bacteriuria.

In this double-blind study, 333 patients (16 males, 317 females) with cystitis or asymptomatic bacteriuria were randomly assigned to receive 200 mg of loracarbef once daily (n = 164; mean age, 36 years) or 250 mg of cefaclor thrice daily (n = 169; mean age, 37 years) for seven days. Cystitis was diagnosed in 97.8% of the evaluable loracarbef-treated patients and 94.4% of the evaluable cefaclor-treated patients. Clinical and bacteriologic responses were assessed in 92 loracarbef-treated patients and 107 cefaclor-treated patients. At the five- to nine-day posttreatment evaluation, a clinical cure was found in 84.5% of the loracarbef-treated patients and in 79.4% of the cefaclor-treated patients and improvement in 3.3% and 7.5%, respectively. The pathogen was eliminated in 76.1% and 72.9%, respectively; new pathogens were identified in 4.3% and 4.7%, respectively; and the original pathogen was not eliminated or recurred in 19.6% and 21.5%, respectively. Nausea was the most frequently reported adverse event (in 4.5% of all patients). The results indicate that both loracarbef and cefaclor are safe and effective in the treatment of uncomplicated urinary tract infections.

Adolescent↗
PubMed2005

[The study of diagnosis and treatment of interstitial cystitis].

OBJECTIVE: To discuss the diagnosis and treatment interstitial cystitis (IC). METHODS: The clinical date of 10 cases of IC (all women) were analyzed. Their age ranged from 31 to 63 years, with a mean of 41 years. Their courses ranged from 1.5 to 7 years, with a mean of 3.4 years. The symptom criteria of the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) was met for IC and no patients had Hunner's ulcer. Potassium sensitivity tests (PST) were performed in all cases. Eight were positive. The O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) was used as treatment outcome measures. ICSI score was from 9 to 20 (mean, 14 +/- 4) at baseline. All the patients were treated with hydrodistention initially. Efficacy was evaluated at 1 month after hydrodistention. The patients who failed to respond to the treatment and recurrence after the treatment were treated by oral or intravesical therapy. RESULTS: The 10 cases were followed up for 3 to 26 months (mean, 7.8 months) after hydrodistention. Five patients obtained symptom relief. Among them, symptom significantly relieved or disappeared in 2, with the score decreased > 7; symptom partially relieved in 3, with the score decreased > 3. Five cases failed to respond to the treatment. Two cases had recurrence 3 and 6 months after the treatment. The effective rate was 50%. The ICSI score was decreased to 11 +/- 6 at 1 month (t = 4.394, P < 0.05) after the treatment. Those who failed to respond or recurrence after hydrodistention were treated by other methods. Two case were treated with oral Pentosan Polysulfate, effective. Three cases were treated with amitriptylin, 2 effective. Three cases were treated with intravesical Dimethyl sulfoxide plus heparin plus dexamethasone, all effective. CONCLUSIONS: The diagnosis of IC should meet the symptom criteria of the NIDDK. PST has significant high positive rate in IC patient, which can be used not only for diagnosis but also for instruction. There are a lot of strategies in the management of patients with IC. Hydrodistention is the first choice.

Adult↗
PubMed1992

Association of chronic interstitial cystitis, protein-losing enteropathy and paralytic ileus with seronegative systemic lupus erythematosus: case report and review of the literature.

We report the case of a female patient with seronegative lupus and predominant bladder and intestinal involvement in the form of interstitial cystitis and protein-losing enteropathy. This association is exceptional in the literature but may be underestimated because of frequent latency of interstitial cystitis. It may define a peculiar subgroup of lupus patients usually responsive to steroid therapy. In this case, only cyclophosphamide markedly improved the protein-losing enteropathy but did not influence the bladder disease.

Adult↗
PubMed2005

[Emphysematous cystitis due to Clostridium perfringens--a localised infection in a man with generalized melanoma].

Emphysematous cystitis was found at autopsy of a 47-year-old man suffering from generalised malignant melanoma. Bacteriological cultures from the urinary bladder showed Escherichia coli, Klebsiella sp. and Clostridium perfringens type A, toxic strain. The histological examination revealed cystic dilatation of lymphatic vessels both in bladder mucosa and muscularis propria. There were multinucleated macrophages in the lining of some of these cystic spaces and a few Gram-positive rods inside their lumina. In the mucosal and submucosal connective tissue there were signs of chronic inflammation and, focally, small haemorrhages. We suppose that the gas production was due to the presence of Clostridium perfringens and believe that the infection of the urinary bladder occurred in relation to the repeated insertion of the catheter into the bladder of a patient with secondary immunosuppression. Emphysematous cystitis was, in our case, a localised clostridial infection without clinical and morphological signs of generalised septicaemia.

Clostridium Infections↗
PubMed2005

Pseudo-tumoral eosinophilic cystitis in a 3 year-old girl.

Eosinophilic cystitis (EC) is an uncommon form of bladder inflammation. It is a rare disorder in children and fewer than 25 cases have been described in the literature. We report a case of eosinophilic cystitis mimicking a bladder tumor in a 3 year-old girl with symptoms of urinary frequency. The diagnosis was confirmed with pathology and she underwent clinical treatment with corticosteroids.

Child, Preschool↗
PubMed2005

Efficacy of prophylaxis in women with sex induced cystitis.

UNLABELLED: Sexual intercourse has been established as one of the most important risk factors for both isolated and recurrent uncomplicated infections of the urinary tract. Prophylactic therapy requires only a small dose of an antimicrobial agent, which is generally given at bedtime for 6 to 12 months. An alternative method is to give an antimicrobial agent for six months post-intercourse. It is still unknown which of the two methods is most effective. A total of 123 women with suspected sexually induced recurrent cystitis (mean age 28 years, range 15 to 65) and a history of recurrent urinary tract infection (UTI) (the last one within the last six months) were subjected to prophylactic therapy for six months. Half of them were treated with low-dose trimethoprim-cotrimoxazole (TMP-SMX) and cefaclor given orally post-intercourse (spontaneous usage), while the other half were treated with low-dose TMP-SMX and cefaclor given at bedtime. The response to the prophylactic therapy was classified as continued cure in 106 cases (86.17%), failure in 13 cases (10.56%), and unknown in four cases (3.25%). TMP-SMX administered in continuous nightly prophylaxis showed similar efficacy and tolerability as cefaclor post-intercourse. OBJECTIVE: To determine the efficacy of prophylaxis in women with recurrent sex induced cystitis and compare the post-intercourse versus the conventional bedtime given long-term, low-dose use of prophylactic antimicrobials.

Adolescent↗
PubMed2005

[Pulmonary tuberculosis and adenovirus-hemorrhagic cystitis after autologous peripheral blood stem cell transplantation for follicular lymphoma].

A 58-year-old man had a relapsed follicular lymphoma (Grade 2) and was treated with mitoxantrone, fludarabine and dexamethasone followed by rituximab, and achieved partial remission. The patient then underwent high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (auto-PBSCT). Three days after starting high-dose therapy, he developed a fever, and a chest X-ray revealed pneumonia in the right lower lung. Despite of the administration of antibiotics and the recovery of neutrophils to normal levels, the pneumonia got worse. Bronchoalveolar lavage (BAL) was performed on day 32, the Ziehl-Neelsen staining of the BAL fluid showed acid-fast bacilli, and the culture grew Mycobacterium tuberculosis. The patient was diagnosed as having pulmonary tuberculosis and placed on an antituberculosis regimen (isoniazid, rifampicin, ethambutol, pyrazinamide). On day 43 he also developed hemorrhagic cystitis due to adenovirus type 11, and on day 49 positive CMV antigenemia was detected, which were treated supportively. On day 75 he developed pneumonia probably due to Pneumocystis jirovecii, which was treated with sulfamethoxazole/trimethoprim. The pulmonary tuberculosis resolved completely 4 months after starting the treatment, and the hemorrhagic cystitis and pneumocystis pneumonia resolved 1 month after the diagnosis. He remains in complete remission 2 years after transplantation.

Adenoviridae Infections↗
PubMed1991

[Pelvic lipomatosis associated with cystitis glandularis--case report].

Pelvic lipomatosis is a rare benign disease of unknown etiology characterized by the proliferation of infiltrating fatty tissue within the deep bony pelvis. These fatty tissue may enclose the pelvic and retroperitoneal organs and various degrees of luminal compression and obstruction may happen. There is no typical presenting symptoms of pelvic lipomatosis. The major diagnostic methods are radiological examinations. CT scan is the definitive test to confirm the diagnosis. Open biopsy may be necessary when the diagnosis is inconclusive. Various treatment modalities have been tried, but only the diet therapy and complete ablation of fatty tissue ever reported to be successful. Cystitis glandularis, a rare proliferative inflammatory disease of the bladder, is reported to occur concurrently with pelvic lipomatosis in a patient. Herein we report a similar case. A middle-aged male patient was admitted with the chief complaint of painless gross hematuria for two weeks. After admission a series of radiological examinations and endoscopic bladder biopsy were performed. He was proved to be a rare case of pelvic lipomatosis associated with cystitis glandularis.

Adult↗
PubMed2006

Emphysematous cystitis in an elderly patient with ulcerative colitis.

Emphysematous cystitis is a rare complication of lower urinary tract infections. The disease is characterized by air within the bladder wall and lumen and commonly occurs in middle-aged diabetic women. Intramural bladder gas seen on imaging is pathognomonic for this condition. The severity of the illness varies widely from cases diagnosed incidentally to patients presenting with life-threatening sepsis. We report the case of an 80-year-old non-diabetic man presenting with emphysematous cystitis after a total colectomy for ulcerative colitis.

Aged, 80 and over↗
PubMed2006

[Diagnosis and treatment of interstitial cystitis: report of 16 misdiagnosed cases].

OBJECTIVE: To investigate the diagnoses and treatment of interstitial cystitis (IC). METHODS: The clinical data of 16 IC patients were analyzed respectively. The patients with urinary frequency, urgency, suprapubic pain and chronic pelvic pain. They were misdiagnosed as chronic cystitis, pelvic inflammation, endometriosis, cystophthisis and urethral syndrome, and were diagnosed finally by the means of pathology or cystoscopy. Among the 16 patients, 4 cases had the operation of ileal reservoir, Two cases had sigmoid-cysto-plasty, and 10 cases had drug treatment. The methods of IC diagnosis and treatment were discussed with the review of literature. RESULTS: The pelvic ache disappeared completely in 4 cases after the operation of ileal reservoir; Two cases after cystoplasty felt lightly discomfortable in perineum occasionally, and their bladder capacity was above 350 ml, no recurrence after operation having been found after follow-up for 24 months and 33 months; Ten cases treated with non-operative treatment improved obviously, with the O'Leary-Sant IC symptom index and IC problem index decreased from 15.4 +/- 4.1, 9.4 +/- 2.7 to 4.1 +/- 2.1 and 5.1 +/- 3.9, respectively. CONCLUSIONS: Sufficient attention should be paid to the diagnosis and differential diagnosis of IC; Early diagnosis and therapeutic alliance with manifold measures can relieve the patients' symptom and improve the quality of life.

Adult↗
PubMed2006

[Ionic solutions and possibilities of prevention of recurrent cystitis].

OBJECTIVE: In view of the importance of the phenomenon of adhesion of bacteria to urothelial cells in the pathogenesis of urinary tract infections, the authors investigated the possibility of decreasing this adhesion by means of a complex ionic solution: La Preste mineral water SUBJECTS AND METHOD: The in vitro adhesion of Escherichia coli P-fimbriae (Gal-Gal pili) to urothelial cells in women with recurrent cystitis was compared in neutral medium and in mineral water and the interaction of this same micro-organism with microparticles coated with Gal-Gal receptors was also studied in the same media. In vivo, urothelial cells of 13 women with a normal urological assessment, presenting recurrent cystitis and a high adhesion capacity, were tested three times a day in relation to the same micro-organism on the first and last day of their course of mineral water therapy RESULTS: In vitro, pretreatment of urothelial cells by mineral water induced decreased adhesion (p=0.001), while pretreatment of bacteria with the same mineral water had no effect. In vivo, adhesion was significantly (p=0.021) decreased 2 to 3 hours after ingestion of mineral water and a significant global reduction of adhesion (p=0.016) was observed between the first and last day of mineral water therapy. CONCLUSIONS: These data show a reduction of adhesion (type P) between Escherichia coli and urothelial cells in the presence of La Preste mineral water, due to an action on urothelial cells. These results indicate the probable role of sulphur and silica in this process, while modulation of adhesion by ions has only been demonstrated to date for calcium and magnesium.

Bacterial Adhesion↗
PubMed1991

A case large protruding cystitis glandularis: clinical, histological and mucin-histochemical study.

A case of large protruding cystitis glandularis is reported. A 36-year-old man was admitted to our hospital due to acute cholecystitis, and large protruding masses were incidentally found in the urinary bladder by abdominal ultrasonography. The histological study revealed that they consisted of a large number of Brunn's nests with or without cysts which were often accompanied with columnar epithelial metaplasia, and of glandular structures closely resembling the colonic crypts. The mucin-histochemical study demonstrated glandular lesions in the bladder secreted colonic type mucin, and endocrine cells positive with Grimelius' staining. A review of literature disclosed 19 clinical cases of cystitis glandularis, since 1970, in Japan, but such a large protruding lesion as this case is rare. We first performed detailed histological and mucin-histochemical studies for this clinical case.

Adult↗
PubMed1991

Emphysematous cystitis: report of a case.

Emphysematous cystitis is characterized by gas collection within the bladder wall and lumen. A case of emphysematous cystitis in a 74-year-old diabetic male is reported. Radiogram demonstrated an enlarged bladder with intraluminal gas.

Aged↗
PubMedDate not supplied

[Alkaline encrusted cystitis: factors affecting prognosis].

Alkaline encrusted cystitis is characterized by the formation of calcareous plaques in the bladder mucosa and submucosa in the presence of several factors: infection by urolithic organisms, earlier pathology of the vesical wall and precipitation of calcium phosphate salts. Treatment includes: urine acidification, correction of the urinary infection and use of acetohydroxamic acid. This paper presents three patients where the response to medical treatment was conditioned by the evolution of the existing vesical impairment. The conclusions state that in the alkaline encrusted cystitis, the concurrent pathology is a major predictor of the disease's future evolution.

Adult↗
PubMed1991

Bowel perforation and interstitial cystitis in childhood systemic lupus erythematosus.

A 13-year-old girl presented with abdominal pain, fever, dysuria, incontinence and pyuria and was subsequently diagnosed as having systemic lupus erythematosus (SLE) with extensive gastrointestinal involvement and an associated interstitial cystitis. Despite aggressive therapy with high dose prednisone and cyclophosphamide she developed a small bowel perforation and subsequently died. The combination of bowel symptoms and interstitial cystitis seems unique to the population with SLE, while the separate complication of bowel perforation carries an extremely poor prognosis in this group of patients.

Adolescent↗